Posted by Estella on September 11, 2006, at 5:38:30
In reply to Re: internet and the manufacture of madness..., posted by finelinebob on September 11, 2006, at 2:58:36
> These problems exist within the research community, not our community. If they can't figure out how to "hit a moving target", then they'd better learn their jobs better.
:-)
Ian Hacking has a surprisingly good theory of "hitting moving targets". I'll try to reconstruct (though I might get it a bit wrong).
He talks about... I think it is called the "looping effect". The notion is...
An ecological niche arises. For example, in France (in some century or other) people had to carry around identity cards and the authorities frequently asked to see them. Then people started travelling.
Then psychiatrists started discovering that some people would go travelling without their identity cards and when the authorities questioned them they denied knowledge of who they were. They wrote down the symptoms and called it a disorder.
Then people hear about the disorder and that in conjunction with the ecological niche resulted in many many many more people travelling without their identity card (dissociative fugue). Dissociative fuge became a legitimate way to express / escape distress. So... More and more people start doing it.
So there is a new ecological niche that leads to some symptoms.
The symptoms are recorded and a concept is invented to categorise the symptoms (dissociative fugue).
The existence of the concept has a 'looping effect' on the symptoms. The notion is that the existence of the concept means that people get to hear about the concept and it becomes a 'socially acceptable way of expressing distress'. Hence... The existence of the concept results in more symptoms and / or slightly different ones.
Then psychiatrists observe slightly different symptoms than they did before.
Then the concept is modified to better capture the symptoms.
Then the concept filters back down to the general public.Etc etc.
He tells the story with Multiple Personality Disorder. The notion there is that there are multiple personalities in one body. Then the concept changed and clinician's don't believe in multiple personalities anymore. Instead they believe in dissociated identities (fragments of selves). There is a significant difference between having more than one self and not even having one!
Consumers tend to underappreciate the difference in conceptual revision between MPD and DID. That was talked about in that paper.
He said that there can be trouble when consumer groups insist on MPD terminology / theory when their clinicians are attempting to show them they don't even have a single self (even less more than one). I have some sympathy... Seems to me he picked some very dodgey support groups though ;-)
He said that Borderline Personality Disorder might go the same way in future.
He said that anorexia support groups tend to be counter-productive (I think I've heard similar things for in person group therapy for anorexia, however so I'm not sure the problems are the result of the internet forum).
And as for a new disorder...
Bollocks. He thought he had discovered a new variety of 'fictitious disorder'. For those people who think they are multiple.I don't know what it is...
How people become so detached...Sure there is a lot of crap out there...
But there is a lot of crap psychiatry out there too...Szasz is surprisingly good. I'd heard a lot of bad things about him (as part of the anti-psychiatry movement).
His main beef is:
1) Social control. Mostly around involountary hospitalisations.
2) Drugging people against their will.I think it is good that he is doing that. Someone needs to. Sometimes you need a person to push hard and be a bit 'out there' in order to really get the topic on the agenda too. He emphasises how mental illnesses are different from physical illnesses.
- mental illnesses are typically disturbances of behaviour (that can't be found on autopsy.
- physical illnesses are typically disturbances of parts of the body (that can be found on autopsy).
- mental illnesses means that people may be locked up against their will.
- you have the right to refuse treatment for physical illness as your constitutional right.
- a psychiatrist (maybe with a judge) decided whether you will be locked up and medicated.
- a family member decided whether you will be hospitalised and treated if you are judged incompetent to decide for yourself.
- lots of controversy over physical illness being objective and mental illness being essentially value laden. lots of controversy...Sasz would be willing to grant that what we call mental illnesses with a bio basis are real bodily diseases. He wouldn't call them mental illnesses anymore however. And he wouldn't think that you should be involountarily locked up and medicated etc. You should be treated with the same respect as someone with a physical illness. If you are incompetent then family members should decide and not psychiatrists.
He is fairly interesting...
poster:Estella
thread:684913
URL: http://www.dr-bob.org/babble/social/20060911/msgs/684945.html